Abstract 20452: Blood Pressure Control and Dipping Patterns in Patients With Resistant Hypertension: Combined Effects of Aldosterone and Sodium
Background: High sodium intake and hyperaldosteronism are independently linked to increased cardiovascular morbidity and mortality. Hyperaldosteronism contributes to resistant hypertension (RHTN) and is associated with higher 24- hour ambulatory blood pressure (BP) levels. Nocturnal hypertension and non-dipping are associated with increased CV risk, but mechanisms are not fully elucidated.
Objective: This study was designed to determine if high dietary sodium intake, and /or hyperaldosteronism mediate the development of abnormal diurnal BP patterns and nocturnal hypertension.
Methods: A single-center cohort of 326 African American (AA) and Caucasian patients with RHTN were evaluated by assessing plasma renin activity (PRA), 24-hr urinary aldosterone (UAldo), sodium (UNa+) levels, and 24-hr ambulatory blood pressure monitoring (ABPM). Daytime, nighttime, and 24-hr BP levels and dipping patterns were determined. High sodium excretion was defined as UNa+ > 200 mEq/24hr and hyperaldosteronism was defined as UAldo > 12 μg/24hr and PRA ≤ 1 ng/ml/hr.
Results: When analyzed for high UNa vs. normal UNa, the latter had lower nocturnal and 24-hr BP levels compared to the high UNa group (p= 0.024 and p= 0.036 respectively), but there was no difference in dipping patterns (Table 1). However, when analyzed for an interaction between aldosterone and sodium, patients with hyperaldosteronism and high UNa were more likely to be non-dippers (Table 2).
Conclusion: High dietary sodium intake contributes to increased nocturnal hypertension and poor 24-h BP control, and the interaction of hyperaldosteronism and high sodium seems to contribute to non-dipping pattern.
Author Disclosures: C. German: None.
- © 2016 by American Heart Association, Inc.